Senior Data Scientist

This is a fully remote position, open to applicants in United States.

📋 Description

• Assist in the Defense Health Agency's Revenue Cycle Operating System initiative.

• Design and build advanced analytics within Databricks utilizing Python, SQL, Spark/PySpark, statistical methods, and machine-learning techniques.

• Create visualizations in Databricks, including Databricks SQL dashboards, AI/BI dashboards, and native visualization capabilities.

• Develop interactive dashboards tailored for DHA J-8, DHN, MTF, revenue-cycle, coding, financial, and executive users.

• Convert analytical models into visual formats that highlight financial exposure, recovery opportunities, trends, root causes, outliers, and suggested operational priorities.

• Construct command-level RevOS SITREP dashboards featuring Healthy/At Risk/Critical indicators across Front, Middle, and Back Office revenue-cycle processes.

• Create drill-down analytics spanning from enterprise and DHN levels down to MTF, department, provider, encounter, claim, and claim-line levels.

• Design analytical models to identify and quantify revenue leakage and recovery opportunities.

• Analyze data related to encounters, documentation, coding, charges, claims, denials, adjudication, payments, and accounts-receivable.

• Formulate detection logic for issues such as missing or incomplete charges, uncoded or delayed encounters, coding errors, claims-readiness defects, denied or rejected claims, underpayments, unmatched remittances, aged claims and receivables, as well as eligibility or authorization failures.

• Create models for recoverability and priority scoring.

• Develop analytics focused on payer performance and denial management.

• Build predictive models to identify revenue-cycle failures before resulting in lost revenue or excessive Days-to-Bill.

• Establish baselines and methodologies for anomaly detection.

• Design financial-impact methodologies to estimate potentially recoverable revenue.

• Develop and validate standardized RevOS KPIs and analytical measures.

• Support the RevOS Revenue Opportunity Ledger.

• Create dashboard views linking aggregate metrics to the Revenue Opportunity Ledger and actionable work queues.

• Collaborate with Data Engineers to ensure Silver and Gold structures facilitate analytics and dashboard performance.

• Optimize analytical queries and calculations for responsive enterprise-scale visualization.

• Validate models, KPIs, and dashboard calculations against authoritative source records.

• Create analytical data products for areas such as coding audits, payer scoring, denial management, revenue recovery, financial reconciliation, and audit remediation.

• Document the purpose, features, methodology, validation, performance, refresh cadence, limitations, and version history of models.

• Support practices related to model monitoring, validation, retraining, and ModelOps.

⛳️ Requirements

• A minimum of 8 years of professional experience in data science, advanced analytics, quantitative analysis, machine learning, or related fields.

• Extensive hands-on experience with Databricks.

• Proven ability to utilize Databricks' native visualization and dashboard features, including Databricks SQL and/or AI/BI dashboards.

• Experience in designing operational, analytical, and executive dashboards based on large-scale enterprise datasets.

• Advanced knowledge of Python and SQL.

• Familiarity with Spark/PySpark or similar distributed-computing technologies.

• Experience in developing predictive models, anomaly detection, classification, prioritization/scoring models, or similar analytical functions.

• Strong grasp of feature engineering, model validation, statistical testing, and quality assurance in analytics.

• Experience with complex datasets in finance, operations, healthcare, claims, payments, or transactions.

• Ability to translate business and operational challenges into measurable analytical hypotheses and production-ready analytical solutions.

• Exceptional ability to convey complex analytical insights through visualizations and dashboards to diverse audiences, both technical and non-technical.

• Experience in developing KPIs that reconcile with authoritative data sources.

• Understanding of modern lakehouse architectures and Bronze/Silver/Gold data structures.

• Ability to collaborate with Data Engineers and Architects to define data structures necessary for analytics and visualization.

• Proven experience in creating auditable and explainable analytical methodologies suitable for financial or regulated environments.

• Capability to function within Agile product-development and iterative delivery frameworks.

• Ability to comply with DHA/DoD security, privacy, access, and data-handling standards.

• Applicants must meet eligibility criteria for a U.S. Government security clearance.

• Only U.S. citizens are eligible for a security clearance.

• LMI will only consider applicants who possess security clearances or are eligible for them.

• Preferred: Prior experience with Advana and/or the current War Data Platform (WDP).

• Preferred: Experience in creating dashboards and analytical products within a DoD Databricks environment.

• Preferred: Familiarity with Databricks Unity Catalog, Delta Lake, Databricks SQL, AI/BI Dashboards, MLflow, Workflows, or related tools.

• Preferred: Experience in healthcare revenue cycle processes, including coding, claims, charge capture, denials, accounts receivable, remittance, payer reimbursement, and underpayment analysis.

• Preferred: Knowledge of healthcare payer transaction data such as 835, 837, 270/271, 276/277, and 278 transactions.

• Preferred: Experience with MHS GENESIS, Oracle Health/Cerner Millennium, Abacus, or similar healthcare systems.

• Preferred: Experience in supporting federal financial management, audit remediation, or revenue recognition initiatives.

• Preferred: Understanding of certified data products, lineage, data governance, and data-quality controls.

• Preferred: Experience in developing explainable AI/ML capabilities in regulated or government environments.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and continuing education.

• Flexible work environment with options for remote work.

• Supportive team culture that values collaboration and innovation.